New Study on Effectiveness of Graphic Cigarette Warnings Should Prompt FDA to Quickly Require Them

WASHINGTON, D.C. – A new study published today by the journal JAMA Internal Medicine provides compelling new evidence that large, graphic cigarette warnings are more effective than text-only warnings at motivating smokers to try to quit. It provides yet another reason why the Food and Drug Administration (FDA) should act quickly to develop and require graphic warnings covering the top 50 percent of the front and back of cigarette packs in the United States, as required by a 2009 federal law, the Family Smoking Prevention and Tobacco Control Act.

The FDA retains the authority to require such warnings under a pair of federal court rulings. While one appellate court ruling (by the U.S. Court of Appeals for the DC Circuit) struck down specific warning labels the FDA had developed to implement the 2009 law, another appellate court ruling (by the U.S. Court of Appeals for the Sixth Circuit) upheld the law’s underlying requirement for graphic warnings. The U.S. Supreme Court in 2013 declined to hear a tobacco industry appeal of the Sixth Circuit ruling, preserving the FDA’s authority to develop new graphic warnings. The FDA said in 2013 that it planned to do so, but has yet to act. It should do so without further delay.

This new study adds to the extensive evidence from around the world that large, graphic health warnings are most effective at informing consumers about the health risks of smoking, discouraging children and other non-smokers from starting to smoke, and motivating smokers to quit. It provides important new evidence showing that graphic health warnings affect the behavior of smokers and make it more likely smokers will try to quit.

The United States needs to update its woefully outdated and nearly invisible cigarette warnings and catch up with the more than 89 countries that now require graphic warnings. This study will also boost efforts to get more countries to adopt graphic warnings. Large, graphic health warnings are an essential component of the overall effort to reduce tobacco use, which kills nearly half a million people in the United States and six million worldwide each year.

The study was conducted by researchers at the University of North Carolina. It followed more than 2,000 adult smokers in North Carolina and California for four weeks and examined how attempts to quit smoking differed between smokers whose packs featured graphic warnings and those who saw text-only warnings.